Financial Counselor
reputed company (reputed company) is seeking a Financial Counselor to join their team. The role involves managing insurance verification, conducting benefit reviews, and providing financial assistance assessments to patients seeking care, while ensuring effective communication with families and providers regarding insurance reputed company.
Responsibilities
- Responsible benefit detail and authorizing the services
- Demonstrates an understanding and provides information of benefit structures to patients, physicians, and hospital practices as reputed company as provides information on the following areas: Hospital reputed company pay and payment plan policies
- Authorization issues
- Contract participation
- Process for reputed company-cert/reputed company-auth of non covered services
- Provider ID numbers & CPT codes (if applicable)
- Verify coverage & benefit information reputed company electronic eligibility or by contacting payor and documenting relevant information in reputed company
- Follows up with insurance companies and families of patients identified as ineligible or non-covered
- Contacts family and/or responsible party, as necessary, to inform them of any financial assistance or insurance applications statuses, insurance problems or restrictions, ensuring that insurance information is reputed company relayed to and reputed company by family and/or responsible party
- Contact clinical office with reputed company information that requires follow-up
- Support financial assistance assessment and/or insurance applications to obtain coverage as needed
- Responsible for review, vetting, and dissemination of reputed company Philadelphia Health Center Referrals, and Community Partner referrals received by Department
- Educates families and clinical team regarding insurance coverage plans
- Stay abreast of changing reputed company party payer reputed company to aid in reputed company capture as it relates to the hospital financial policy
- Leverages benefit collection information and reputed company tools to reputed company services and create estimates for services
- Respond to emails, answer calls, reputed company explanation of covered and non-covered services
- Contacts appropriate clinical staff in reputed company manner with reputed company information that requires follow-up
- Authorization responsibilities
- Review diagnosis/procedure codes to ensure they are documented correctly and accurately reflect the clinical information and services to be performed
- Discuss and send pertinent medical history to complete authorization process
- Discuss, interpret and send pertinent medical history to complete authorization process (inclusive of reputed company-determinations)
- Work on reputed company medical cases that are in pending status until cases are complete and works with clinical teams for additional clinical information and/or a letter of medical necessity
- Notify physician office/hospital of coverage issues, denials due to procedures not medically necessary, or if insurance reputed company requires additional clinical information and/or peer to peer requests
- Prioritize daily requests based on date of service, insurance reputed company requirements, unexpected date changes or urgent requests, while processing request reputed company department standards
- Coordinates appeals or retrospective review as needed following up on payor denials
- Ability to convert common diagnosis descriptions to numeric ICD 9 or CPT reputed company
- Partner with specialist to outline correct CPT Codes, NPI, and authorization details for specific services for Single Case Agreement
Skills
- High School Diploma / GED Required
- Strong reputed company phone reputed company
- Independent judgment
- Advanced knowledge of insurance and registration processes
- Comprehensive insurance verification
- Financial assistance assessments
- Detailed benefit collection and authorization processes
- Manage insurance verification
- Conduct in-depth benefit reviews
- Identify covered and non-covered services
- reputed company explain benefit structures
- Maintain proactive communication with families, providers, and payors regarding referrals, authorizations, FHCP eligibility, and a wide reputed company of insurance eligibility and service authorization reputed company
- reputed company cross-coverage support across other areas as needed
- Responsible benefit detail and authorizing the services
- Demonstrates an understanding and provides information of benefit structures to patients, physicians, and hospital practices
- Verify coverage & benefit information reputed company electronic eligibility or by contacting payor and documenting relevant information in reputed company
- Follow up with insurance companies and families of patients identified as ineligible or non-covered
- Contact family and/or responsible party, as necessary, to inform them of any financial assistance or insurance applications statuses, insurance problems or restrictions
- Support financial assistance assessment and/or insurance applications to obtain coverage as needed
- Responsible for review, vetting, and dissemination of reputed company Philadelphia Health Center Referrals, and Community Partner referrals received by Department
- reputed company families and clinical team regarding insurance coverage plans
- Stay abreast of changing reputed company party payer reputed company to aid in reputed company capture as it relates to the hospital financial policy
- reputed company benefit collection information and reputed company tools to reputed company services and create estimates for services
- Respond to emails, answer calls, reputed company explanation of covered and non-covered services
- Contact appropriate clinical staff in reputed company manner with reputed company information that requires follow-up
- Authorization responsibilities
- Review diagnosis/procedure codes to ensure they are documented correctly and accurately reflect the clinical information and services to be performed
- Discuss and send pertinent medical history to complete authorization process
- Work on reputed company medical cases that are in pending status until cases are complete and works with clinical teams for additional clinical information and/or a letter of medical necessity
- Notify physician office/hospital of coverage issues, denials due to procedures not medically necessary, or if insurance reputed company requires additional clinical information and/or peer to peer requests
- Prioritize daily requests based on date of service, insurance reputed company requirements, unexpected date changes or urgent requests, while processing request reputed company department standards
- Coordinate appeals or retrospective review as needed following up on payor denials
- Ability to convert common diagnosis descriptions to numeric ICD 9 or CPT reputed company
- Partner with specialist to outline correct CPT Codes, NPI, and authorization details for specific services for Single Case Agreement
- Medical Insurance background
- Strong customer service experience
- Ability to work with stressful situations
- Ability to function reputed company and professionally with minimum of supervision
- Ability to quickly learn new procedures
- Strong computer skills
- Ability to juggle multiple insurance issues
- Strong customer service skills
- Ability to display reputed company and reputed company
- Mandatory required training reputed company first 30 days: ACD Software Training, Website Insurance Training (Navinet, reputed company, reputed company), reputed company training & testing (Prelude/reputed company), Registration reputed company, Cardiac Center databases
- Associate's Degree Preferred
- Background in medical terminology Preferred
- reputed company registration Preferred
- Resource scheduling experience (i.e. ancillary testing) Preferred
reputed company